This study explores barriers to antiretroviral therapy (ART) adherence among postpartum women living with HIV in rural South Africa using a participatory action research (PAR) approach. The study, conducted in Ngqushwa Municipality, Eastern Cape, involved ten women as co-researchers using Photovoice to document their experiences. The findings revealed anticipated stigma and poverty as major barriers. Anticipated stigma significantly impacted women's ability to collect, store, and take ARVs without fear of disclosure. Poverty exacerbated this by limiting access to food, housing, and economic opportunities. The co-researchers played a leading role in designing a community-led program, "Lelethu," to address these barriers through life planning, stigma reduction initiatives, economic empowerment, and peer support. This PAR methodology demonstrated its effectiveness in understanding and addressing ART adherence, emphasizing improved quality of life as a primary outcome.

Katy Pepper